Chronic disease is the leading cause of death in the United States with nearly 7 out of 10 deaths attributed to chronic health conditions. In 2005, almost 1 out of every 2 Americans had a chronic illness and one-quarter had at least one day-to-day functional limitation. Chronic illnesses such as cardiovascular disease, diabetes, Alzheimer's, and HIV/AIDS are associated with higher rates of depression and anxiety than in the general population. Mounting evidence points to the detrimental impact of many chronic illnesses on neurocognitive functioning. In addition, neurocognitive impairment (NCI) (e.g. deficits in executive functioning, memory, attention) and emotional distress can directly impact chronic illness via reduced capacity and motivation for self-care; emotional distress can dysregulate neuroendocrine cascades and negatively impact immune function also worsening disease. NCI and affective distress can be interdependent as well; the existence of one symptom potentially compounding the effects of the other. Therefore, affective and cognitive symptoms can potentiate a negative course of illness through both physiological and behavioral pathways; disruption of these pathways has the potential to reduce this negative progression. The proposed Center for Cognition and Affect in Chronic Illness in the Nell Hodgson Woodruff. School of Nursing at Emory University seeks to produce new knowledge that will elucidate the underlying mechanisms of and complex interactions between affective and cognitive symptoms in chronic illnesses. The overarching goal of the proposed Center is to promote, support, and serve as an incubator for research studying the etiology, identification, assessment, and effective treatment of affective and cognitive symptoms of chronic illness. Through centralized research resources and infrastructure, the Center will promote and sustain interdisciplinary research activities and independent programs of nursing research to advance the science of affective and cognitive symptoms. PUBLIC HEALTH RELEVANCE: As the US population continues to age, the prevalence of chronic illness and associated affective and cognitive symptoms will increase. Efforts to understand symptom-symptom and symptom-illness interactions and the mechanisms underlying development and maintenance of these symptoms and the progression of the illnesses can inform interventions to ameliorate their impact on the health and well-being of a large segment of the population.